Table 1.
Characteristics for 4,615 persons who underwent isolated, primary, continuous flow LVAD implantation in 2016 and 2017 in the US, from the INTERMACS database, by kidney function trajectory group.
| CHARACTERISTICS | 1 (n=2138) |
2 (n=1780) |
3 (n=468) |
4 (n=150) |
5 (n=79) |
P-value |
|---|---|---|---|---|---|---|
|
| ||||||
| Demographics | ||||||
|
| ||||||
| Age (years) | 63 (56–69) | 53 (41–61) | 62 (54–69) | 54 (42–63) | 55 (42–64) | <0.001 |
| Female | 21.6% | 19.9% | 23.9% | 24.0% | 21.5% | 0.31 |
| Race | ||||||
| Black | 23.1% | 27.4% | 25.6% | 30.0% | 32.9% | 0.008 |
| White | 67.0% | 59.8% | 63.9% | 56.7% | 54.4% | <0.001 |
| Asian | 1.7% | 2.0% | 1.7% | 0.7% | 2.5% | 0.73 |
| Other and unknown | 4.6% | 5.5% | 5.1% | 8.0% | 5.1% | 0.36 |
| Hispanic ethnicity | 6.6% | 8.3% | 7.3% | 14.0% | 7.6% | 0.055 |
| Vital signs | ||||||
|
| ||||||
| BMI (kg/m2) | 28.4 (24.7– 33.0) | 26.5 (23.0–31.6) | 28.6 (24.5–34.2) | 26.8 (22.5–31.8) | 27.9 (23.4–32.1) | <0.001 |
| BSA (m2) | 2.1 (1.9–2.3) | 2.0 (1.8–2.2) | 2.1 (1.9–2.3) | 2.0 (1.8–2.2) | 2.1 (1.8–2.2) | <0.001 |
| Peri-implantation factors | ||||||
|
| ||||||
| Device strategy | <0.001 | |||||
| Bridge to transplant | 23.3% | 24.8% | 24.1% | 24.0% | 19.0% | |
| Possible bridge to transplant | 21.5% | 31.1% | 22.0% | 31.3% | 33.0% | |
| Destination therapy | 54.7% | 43.4% | 53.2% | 44.7% | 45.6% | |
| INTERMACS profile | <0.001 | |||||
| Critical cardiogenic shock (1) | 13.4% | 18.3% | 27.7% | 33.3% | 36.7% | |
| Progressive decline (2) | 33.7% | 34.0% | 35.8% | 35.3% | 32.9% | |
| Stable, inotrope dependence (3) | 39.0% | 36.6% | 28.3% | 25.3% | 22.8% | |
| Resting symptoms or lesser severity (4–7) | 13.9% | 11.2% | 8.2% | 6.0% | 7.6% | |
| Interventions within 48 hours prior to implantation | ||||||
| IV inotrope | 83.6% | 84.6% | 89.1% | 92.0% | 87.3% | 0.017 |
| Dialysis | 0.1% | 0.0% | 50.0% | 7.3% | 3.8% | <0.001 |
| ECMO | 2.2% | 3.5% | 5.6% | 6.0% | 11.4% | <0.001 |
| IABP | 15.5% | 16.9% | 20.3% | 16.7% | 19.0% | 0.145 |
| Implantation surgery | ||||||
|
| ||||||
| Cardiopulmonary bypass time (min) | 84 (63–114) | 80 (61–108) | 90 (64–126) | 83 (64–125) | 96 (65–137) | <0.001 |
| Surgery Time (min) | 269 (213–351) | 255 (204–320) | 288 (219–383) | 270 (214–363) | 278 (227–332) | <0.001 |
| Aortic cross-clamp used | 17.7% | 16.4% | 21.8% | 16.7% | 16.5% | 0.37 |
| Centrifugal VAD | 34.5% | 39.2% | 42.7% | 42.0% | 48.1% | <0.001 |
| Cardiac history and presentation | ||||||
|
| ||||||
| Cardiac disease first diagnosed within 1 month prior | 69 ( 3.2) | 116 ( 6.5) | 28 ( 6.0) | 15 (10.0) | 9 (11.4) | <0.001 |
| Pulmonary hypertension | 443 (20.7) | 322 (18.1) | 88 (18.8) | 23 (15.3) | 15 (19.0) | 0.20 |
| Comorbidities | ||||||
|
| ||||||
| Documented chronic kidney disease | 593 (27.7) | 152 ( 8.5) | 193 (41.2) | 33 (22.0) | 16 (20.3) | <0.001 |
| Diabetes, “severe” classification by INTERMACS | 11.6% | 7.1% | 11.1% | 11.3% | 6.3% | <0.001 |
| Lab results | ||||||
|
| ||||||
| BUN (mg/dl) | 28 (21–38) | 19 (14–25) | 37 (27–54) | 32 (20–43) | 24 (17–40) | <0.001 |
| Creatinine, serum (mg/dl) | 1.5 (1.2–1.7) | 1.0 (0.8–1.1) | 1.9 (1.5–2.5) | 1.6 (1.3–1.9) | 1.1 (0.9–1.4) | <0.001 |
| Total bilirubin (mg/dl) | 0.9 (0.6–1.4) | 0.9 (0.6–1.6) | 1.1 (0.7–1.8) | 1.4 (0.7–2.1) | 1.3 (0.7–2.0) | <0.001 |
| Hemoglobin (g/dl) | 11.1 (9.6–12.5) | 11.4 (9.8–12.9) | 10.0 (8.7–11.5) | 10.1 (8.7–12.0) | 10.0 (8.7–12.0) | <0.001 |
| Albumin, serum (g/dl) | 3.5 (3.1–3.8) | 3.5 (3.0–3.8) | 3.3 (2.8–3.7) | 3.3 (2.9–3.7) | 3.3 (2.7–3.6) | <0.001 |
Notes: Median and interquartile range are given for continuous variables. Percentages are given for categorical variables. The primary and internal validation cohorts are combined for this table.
Abbreviations: INTERMACS, Interagency Registry for Mechanically Assisted Circulatory Support; BMI, body mass index; BSA, body surface area; ECMO, extracorporeal membrane oxygenation; IABP, intra-aortic balloon pump; VAD, ventricular assist device; BUN, blood urea nitrogen